From the Research
For a patient with mononucleosis (mono), treatment is primarily supportive care as this viral infection caused by Epstein-Barr virus typically resolves on its own within 2-4 weeks. Recommend adequate rest, increased fluid intake, and over-the-counter pain relievers like acetaminophen (500-1000mg every 6 hours, not exceeding 4000mg daily) or ibuprofen (400-600mg every 6-8 hours with food) to manage fever and sore throat, as suggested by 1. Gargling with warm salt water (1/2 teaspoon salt in 8oz warm water) several times daily can help relieve throat discomfort. Patients should avoid strenuous physical activity and contact sports for at least 3-4 weeks, even after feeling better, due to the risk of splenic rupture from an enlarged spleen, which occurs in about 50% of cases, as noted in 2. Alcohol should be avoided during recovery as the liver may be temporarily affected. Corticosteroids are occasionally prescribed for severe throat inflammation or significant tonsillar enlargement causing airway obstruction, but aren't routinely recommended, as found in 3. Most importantly, mono is contagious through saliva, so patients should avoid sharing drinks, food, or personal items, and practice good hand hygiene to prevent transmission to others. Recovery time varies, but patients typically can resume normal activities gradually as symptoms improve, while monitoring for rare complications like severe fatigue lasting beyond a month.
Some key considerations in managing mono include:
- The use of corticosteroids is not universally recommended and should be reserved for cases with severe symptoms or complications, as discussed in 4.
- The risk of splenic rupture is a significant concern, and patients should be advised to avoid contact sports and strenuous activity for an appropriate period, as recommended in 1.
- Good hygiene practices are essential to prevent the spread of the infection, given its contagious nature through saliva, as mentioned in 2.
- Monitoring for complications and providing supportive care are crucial in managing the condition effectively, as outlined in 5.
Given the most recent and highest quality evidence from 1, the primary approach to treating mononucleosis should focus on supportive care, with an emphasis on rest, hydration, and symptom management, rather than relying on corticosteroids or other interventions unless absolutely necessary.